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A Keratoconus case with acute hidrops, BCVA hand motion in OS, huge tear of Descemet in visual axis and acute edema commiting the cornea. We thought about try a new treatment aproach,replacing the affected membrane by a new one through DMEK procedure. One month later patient achived 20/50 with correction and cornea recovered the transparency. We believe that DMEK could be a new alternative for treatment of acute hidrops and avoid in some cases penetrate keratoplasty.